Frontiers in medicine · 2026
Case Report: Subcapsular hematoma post-transarterial embolization and its laparoscopic resolution.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Yi Haizhao, Wang Qi, Bai Xuecong, Liu Jinlong, Fu Hua
Аннотация
BACKGROUND: Hepatic hemangioma (HH) is a common benign liver tumor. Transarterial embolization (TAE) is a widely adopted minimally invasive treatment. Subcapsular hematoma (SCH) is an exceptionally rare and severe complication following TAE, with only sporadic cases reported and no standardized management protocol.
CASE PRESENTATION: A 43-year-old female presented with acute right upper quadrant pain 8 days after an attempted TAE for a caudate lobe HH at another institution, which had been aborted due to unsuccessful vessel cannulation. Upon admission, contrast-enhanced CT revealed a large SCH in the right hepatic lobe alongside the known caudate lobe HH. Her condition rapidly deteriorated, with a significant decline in hemoglobin and signs of hemorrhagic shock, necessitating emergency intervention. She subsequently underwent a simultaneous laparoscopic procedure consisting of evacuation of the massive SCH (approximately 2000 mL) and enucleation of the giant caudate lobe hemangioma. The surgical strategy included a left-sided approach, utilization of the Arantius ligament as a key anatomical landmark, and low central venous pressure (CVP) anesthesia to minimize intraoperative bleeding.
CONCLUSION: This case represents, to our knowledge, the first report of SCH as a complication following hepatic artery angiography or attempted TAE and the only reported case of simultaneous laparoscopic management of both a ruptured SCH and a caudate lobe HH. It highlights that SCH, although rare, can be a life-threatening complication of endovascular procedures. Laparoscopic surgery is a feasible and effective therapeutic option for managing such complex conditions. This report underscores the critical importance of meticulous technique during TAE and vigilant postoperative monitoring to prevent this serious complication.
CASE PRESENTATION: A 43-year-old female presented with acute right upper quadrant pain 8 days after an attempted TAE for a caudate lobe HH at another institution, which had been aborted due to unsuccessful vessel cannulation. Upon admission, contrast-enhanced CT revealed a large SCH in the right hepatic lobe alongside the known caudate lobe HH. Her condition rapidly deteriorated, with a significant decline in hemoglobin and signs of hemorrhagic shock, necessitating emergency intervention. She subsequently underwent a simultaneous laparoscopic procedure consisting of evacuation of the massive SCH (approximately 2000 mL) and enucleation of the giant caudate lobe hemangioma. The surgical strategy included a left-sided approach, utilization of the Arantius ligament as a key anatomical landmark, and low central venous pressure (CVP) anesthesia to minimize intraoperative bleeding.
CONCLUSION: This case represents, to our knowledge, the first report of SCH as a complication following hepatic artery angiography or attempted TAE and the only reported case of simultaneous laparoscopic management of both a ruptured SCH and a caudate lobe HH. It highlights that SCH, although rare, can be a life-threatening complication of endovascular procedures. Laparoscopic surgery is a feasible and effective therapeutic option for managing such complex conditions. This report underscores the critical importance of meticulous technique during TAE and vigilant postoperative monitoring to prevent this serious complication.